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Being responsive to citizens’ expectations: the role of health services in responsive-ness and satisfaction.

Busse R, Valentine N, Lessof S, Prasad A, Van Ginneken E
In: MCKEE M, FIGUERAS J (eds.) Health Systems: Health, Wealth and Societal Well-Being. Maidenhead: OUP/ McGraw-Hill, p. 175-208




The world health report 2000 on the performance of health systems posited responsiveness to citizens' expectations as a central and particular goal. It pushed forward a debate that frames responsiveness as a valued and desired outcome of health system interventions regardless of the extent to which those interventions lead to health improvement. First, this chapter explores the basic concepts behind responsiveness, satisfaction and related terms. The following three sections consider the major approaches and actors to measure them, i.e. primarily WHO, but also the European Union and initiatives to ensure patient orientation such as the Picker Institute's questionnaire for inpatient care or the European Task Force on Patient Evaluations of General Practice (EUROPEP) instrument to assess primary care. It then describes comparative methodology and results, and continues with shedding some light on the objectives and achievements of the main recent reforms aimed at increasing responsiveness in European health systems. The chapter concludes with some reflections about the significance of making responsiveness a health system goal and its instrumental value for reaching other goals.

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